In country of poor, why force costly life support, asks SC

What forced Justice A K Sikri, part of the five-judge bench led by CJI Dipak Misra, to dwell on economics while favouring passive euthanasia was the spiralling daily expense in hospitals to keep a terminally ill person on life support system, often spelling financial ruin for poor families.

NEW DELHI: In the process of building a constitutional link between right to life and right to die, the Supreme Court said the economics of extending the life of a terminally ill person with no hope of revival did not make sense in a country where the majority is not able to afford health services.

What forced Justice A K Sikri, part of the five-judge bench led by CJI Dipak Misra, to dwell on economics while favouring passive euthanasia was the spiralling daily expense in hospitals to keep a terminally ill person on life support system, often spelling financial ruin for poor families.

Devoting a separate chapter on ‘Economics of Euthanasia’ in his 112-page judgment, Justice Sikri said, “When we consider the matter of euthanasia in the context of economic principles, it becomes another reason to support the aforesaid conclusion. This aspect can be dealt with in two ways.

“First, because of rampant poverty where majority of the persons are not able to afford health services, should they be forced to spend on medical treatment beyond their means and in the process compelling them to sell their house property, household things and other assets which may be means of (their) livelihood. Second, when there are limited medical facilities available, should a major part thereof be consumed on those patients who have no chances of recovery?”

Explaining the importance of applying cost-benefit test even to constitutional principles, Justice Sikri said, “At times, for deciding legal issues, economic analysis of law assumes importance. It is advocated that one of the main reasons which should prompt philosophers of law to undertake economic analysis seriously is that the most basic notion in the analysis — efficiency or Pareto optimality — was originally introduced to help solve a serious objection to the widely held moral theory, utilitarian.

“Utilitarians hold that the principle of utility is the criterion of the right conduct. If one has to evaluate policies in virtue of their effect on individual welfare or utility, one norm of utility has to be compared with that of another. We may clarify that this economic principle has been applied in a limited sense only as a supporting consideration with the aim to promote efficiency.”

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